AIDS: A Darwinian Event

1
AIDS A Darwinian Event?

• by
• Alan Whiteside1 Alex de Waal2
• The Centre for AIDS Research
• University of Southampton
• 1. Director HEARD University of KwaZulu-Natal
  
• 2. Research Fellow, Global Equity Initiative,
  Harvard University

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Outline of Presentation

• What do I mean - Darwinian
• - Event
• Evidence
• Looking back

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What do I mean?

• Darwinian that which results in change in our
  genetic, social, economic or psychological makeup

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What do I mean?

• Event something we can measure as we look back
  or, in the case of AIDS, look forward

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Examples

• The Black Death (see Barbara Tuchman A Distant
  Mirror)
• The extermination of colonial times Tasmania
• Slavery?
• SMS texting with mobile phones?

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What is AIDS?

• HIV / AIDS an historical event so what is our
  historical perspective
• A candidate as a Darwinian Event?

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Outline of Presentation

• What do I mean - Darwinian
• - Event
• Evidence
• Looking back

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The Scale of the Epidemic

• HIV prevalence of 40
• Mortality

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A model of future AIDS and non-AIDS deaths
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Numbers infected, sick dead ASSA2000
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Changing life expectancy in African countries
with high and low HIV prevalence 1950-2005
Source UNAIDS, 2002. Report on the global
HIV/AIDS epidemic
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Changes in Population Structure due to AIDS
2000-2025
South Africa
Botswana
32
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AIDS orphans in South Africa
33
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Forecast GDP Growth 2002- 15
17
30
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What goes around comes around
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Outline of Presentation

• What do I mean - Darwinian
• - Event
• Evidence
• Looking back

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Demography

• Size (decrease, stabilise, grow more slowly)
• Structure malefemale, dependency ratios
• orphans

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Social/psychological

• Selection by
• Wealth
• Skills
• Ability or characteristics eg artists or
  entrepreneurs

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Wealth and HIV
Botswana
South Africa
3000
Namibia
2000
Swaziland
1000
Cote dIvoire
Zimbabwe
Uganda
Zambia
Per capita 1999
10
10
20
30
Adult HIV prevalence end 1999
23

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Some Populations Harder Hit than Others
Intro.
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Memetic evolution

• Memes are replicable information in the brain.
• Circumcision
• Risk taking
• Funeral ceremonies
• Nepotism and altruism

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Is AIDS a Darwinian event?

• Yes
• Populations decline
• Some groups v.adversely affected
• Memetic impact
• Economic social effects

• No
• Pop. Decline limited
• Epidemic isolated in certain areas groups
• The dyers dont matter
• The scale too short

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Ozymandias

• I met a traveler from an antique landWho said
  Two vast and trunkless legs of stoneStand in the
  desert. Near them, on the sand,Half sunk, a
  shattered visage lies, whose frown,And wrinkled
  lip, and sneer of cold command,Tell that its
  sculptor well those passions read,Which yet
  survive, stamped on these lifeless things,The
  hand that mocked them, and the heart that
  fed,And on the pedestal these words appear"My
  name is Ozymandias, King of KingsLook upon my
  works, ye Mighty, and despair!"Nothing beside
  remains. Round the decayOf that colossal wreck,
  boundless and bareThe lone and level sands
  stretch far away.
• Percy Bysshe Shelley1792-1822

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No Man is an Island

• No man is an island, entire of itself every man
  is a piece of the continent, a part of the main
  if a clod be washed away by the sea, Europe is
  the less, as well as if a promontory were, as
  well as if a manor of thy friends or of thine own
  were any man's death diminishes me, because I am
  involved in mankind and therefore never send to
  know for whom the bell tolls it tolls for thee.
  -- John Donne

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HIV/AIDS is an historical event!

• A history is being written.
• The responsibilityof historians provide
• ideas,
• paradigms
• methodologies for understanding and responding

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And finally

• There is an awful predictability about HIV/AIDS
  and what it has the potential to do.
• Historians have the unique experience of seeing
  an event of unparalleled significance unfold
  before their eyes. This history can be written in
  advance.